| Objective:To investigate the immune function status and its clinical significance of patients with non-small cell lung cancer(NSCLC)which have different clinical features,and to recognize the correlation analysis between prognostic factors with immune functionstatus of non-small cell lung cancer,Establish an immunoprognostic evaluation model,in order to provide reference for clinical immune regulation strategies in patients with NSCLC.Methods:1.Select 51 patients with newly diagnosed non-small cell lung cancer(NSCLC)whowere admitted to Qingdao Municipal Hospital from December 2016 to December 2017 as bronchial lung cancer group.The average age of the patients was 63.72±8.34 years old.There were 36 males and 15 females;23 smokers and 27 nonsmokers;44 cases of adenocarcinoma and 7 cases of squamous cell carcinoma;TNM stage of non-small cell lung cancer:28 cases of stage I-IIIA and 36 cases of stage IIIB-IV.In addition,30 healthy people who were in physical examination at the physical examination center of Qingdao Municipal Hospital were selected as the control group.There was no difference in age,gender,and bronchial lung cancer group(NSCLC patients).2.Flow cytometry was used to detect the expression of lymphocyte subsets in peripheral blood of patients with newly diagnosed bronchial lung cancer(NSCLC patients)before and during treatment(healthy people),including:CD45%,CD3+%,CD4+%,CD8+%,CD4+/CD8+ ratio,Tc%(CD8+CD28+ cells),Ts%(CD8+CD28-cells),Tre-g%(CD4+CD25+ cells),CD4+CD8+%(double positive cells),CD4-CD8-%(double Negative cells),CD19+%(B cells),NK%(CD16+CD56+ cells).3.All patients were followed up for 12 months,and the patients with bronchial lung cancer were evaluated again.According to the prognosis,patients with bronchogenic lung cancer were divided into good prognosis group(29 cases)and poor prognosis group(22cases).4.After the data collection was completed,the expression levels of peripheral blood lymphocyte subsets in the bronchial lung cancer group(NSCLC patients)and the control group were compared and analyzed.At the same time,the expression levels of peripheral blood lymphocyte subsets in patients with different genders,ages(≧65 years and <65years old),smoking,clinicopathological classification and clinical stage were compared between the bronchial lung cancer group(NSCLC patients).The prognostic factors of the bronchial lung cancer group(NSCLC patients)were analyzed,and a prognostic evaluation model was established.Result:1.All patients with non-small cell lung cancer who participated in the clinical study were complete and successfully completed the study without any withdrawal or death.2.There was no significant difference in gender(χ2=0.791>0.05)and age(t=0.574>0.05)between the bronchial lung cancer group(NSCLC patients)and the control group(healthy people)(p>0.05).).The ratio of CD45%,Treg% and CD4+/CD8+ in peripheral blood of patients with bronchial lung cancer was significantly different from that of healthy controls(p<0.05).There were no significant differences in peripheral blood CD3+%,CD4+%,CD8+%,Tc%,Ts%,CD4+CD8+%,CD4-CD8-%,CD19+%,NK%between the two groups(p>0.05).3.There were no significant differences in peripheral blood lymphocyte subsets between the bronchial lung cancer patients of different genders and ages(≧65 years and<65 years old)(p>0.05).The NK% of smoking patients in the bronchial lung cancer group was significantly lower than that of non-smokers,and the difference was statistically significant(p < 0.001).In the bronchial lung cancer group,the patients with stage I-IIIA,CD4+%(p = 0.001 <0.05),CD4+/ CD8+cell ratio(p = 0.027 <0.05)was higher than stage IIIB-IV,and the difference was statistically significant.The immune function of patients with stage I-IIIA is better than that of patients with stage IIIB-IV.4.There were no significant differences in the prognosis group(29 cases)and the poor prognosis group(22 cases)in gender,smoking,clinical stage,and pathological type(p>0.05).The age difference was statistically significant(p < 0.05).Peripheral blood CD45%,CD3+%,and CD4+% were lower in the poor prognosis group than in the control group(p<0.05);peripheral blood Treg cells were higher than the prognosis group(p<0.05).The remaining CD8+%,CD4+/CD8+ ratio,Tc%,Ts%,CD4+CD8+%,CD4-CD8-%,CD19+%,NK% were not statistically significant(p>0.05).5.Multivariate logistic regression analysis was performed on the results of the differences between the two groups.Age(OR=0.969)and blood CD45%(OR=0.872),CD3+%(OR=0.977),CD4+%(OR=0.84),Treg%(OR=12.703),CD4+% and Treg% were the prognostic factors of patients with bronchial lung cancer(NSCLC)(p<0.05).6.These prognostic factors were established by statistical regression to establish a prognostic evaluation model:Logit P = 9.136-0.175*CD4%+2.542*Treg%,P represents prognosis,the model is based on 0.5,P < 0.5 is 0,which means that the prognosis is good,P>0.5 is classified as 1 class,indicating poor prognosis.The model prediction accuracy is90.2%.Conclusion:1.Patients with non-small cell lung cancer have immune function inhibition in healthy people.2.The expression level of peripheral blood lymphocyte subsets in non-small cell lung cancer has a certain relationship with clinical stage and smoking.The later the clinical stage,the worse the immune function of patients with bronchial lung cancer who smoked.3.Age(≥65 years old and <65 years old),CD45%,CD3+%,CD4+%,and Treg%were the prognostic factors in patients with non-small cell lung cancer.Age <65 years,CD45%,CD3+%,CD4+%,and Treg% are protective factors for prognosis.Treg% is a risk factor for prognosis in patients with non-small cell lung cancer.4.By measuring the peripheral blood CD4+ cell fraction and Treg cell score,according to the immune prognosis evaluation model,we can judge the condition of non-s-mall cell lung cancer patients,understand the immune function of the body,evaluate the prognosis,and provide reference for clinical application of immunopotentiators,and have certain guidance for NSCLC treatment. |
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